Hospital: Department of Neuroscience Imaging and Clinical Sciences- S.S. Annunziata Hospital - Chieti.
Aut@r o Autores: D.A. Caposiena, B. Seccia, B. Faricelli, E. Mincuzzi, A. Delli Pizzi, R. Basilico.
A 26 years old man was admitted in the Emergency Room with sudden onset of painful priapism after penile trauma. The clinical examination showed painful subcutaneous swelling of the right lower penis wall. Remote and near pathological anamnesis was not significant, laboratory exams showed no significant alterations. Doppler US in emergency and subsequent ce-MRI were performed.
Doppler US (A) showed focal interruption of the tunica albuginea of the right corpus cavernosum in the swelling site, with evidence of herniated tissue through the breach. Some ectatic veins with high velocity flow were evident at the periphery of the herniated tissue. T2W-TSE MRI acquisitions (B) confirmed the presence of a 5mm focal interruption of the right tunica albuginea with evident herniation of an inhomogeneus hypointense tissue of about 3.4 cm in diamater. T1W-GE 3D non-enhanced (C) and enhanced (D) acquisitions with fat suppression showed multiple hyperintense images compatible with multiple hematomas and lacerations in the context of the herniated tissue. Multiple ectatic veins were evident on the periphery of the herniated tissue.
The patient underwent urological surgery which confirmed the herniation of the right corpus cavernosum associated with the presence of a fissured venous malformation, probably of post-traumatic origin, strongly adherent to the ipsilateral tunica albuginea. Complete resection of the malformation, reduction of the herniation and suture of the right tunica albuginea were performed, with no consequences on the penile functionalityof the patient.
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